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In a New Win for Providers, No Surprises Act Rules Struck for Allowing Ghost Rates
Kramer Levin Link to more items from this source
Aug. 31, 2023

"The district court agreed that the QPA methodology outlined in the regulations ... deviated from the NSA statutory requirements, and it vacated those regulations as well as two other regulations governing the claim and IDR process.... [This case] represents a significant victory for providers because it shuts the door to certain types of tactical behavior by insurers around QPA calculations, and it has led the agencies to call for a total halt of the NSA IDR process while they come up with a plan to comply with TMA III pending appeal." [Texas Medical Association v. HHS, No. 22-450 (E.D. Tex. Aug. 24, 2023)]  MORE >>

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